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Friday, May 27, 2011

Societal adoption of communism and of assisted suicide and euthanasia follows a similar deceptive, tragic trail. Activists advance beguiling arguments of compassion, dignity and autonomy, convincing society to adopt the ideology. Once that ideology translates into real world practice, however, the result is violence, abuse and loss of freedom.

Even those with no moral objection to assisted suicide and its close cousin, euthanasia, should follow the trail of tragedy when these concepts are actually implemented in countries like the Netherlands and Belgium and in states like Oregon and Washington. An incisive article by J. Pereira, MBChB MSc published in Current Oncology, entitled, "Legalizing euthanasia or assisted suicide: the illusion of safeguards and controls," reveals the impotence of supposed legal safeguards and traces the deadly path of medical killing run amok.

The medical journal article finds that:

Patients are being put to death without consent:

·"Despite … safeguards, more than 500 people in the Netherlands are euthanized involuntarily every year."

·"In Belgium, the rate of involuntary and non-voluntary euthanasia deaths (that is, without explicit consent) is 3 times higher than it is in the Netherlands."

·"The United Nations has found that the euthanasia law in the Netherlands is in violation of its Universal Declaration of Human Rights because of the risk it poses to the rights of safety and integrity for every person’s life."

Doctors are hiding euthanasia from authorities

·"In Belgium, nearly half of all cases of euthanasia are not reported…"

·"In the Netherlands, at least 20% of cases of euthanasia go unreported."

Consultation requirement is being filled by biased doctors

·"In Oregon, a physician member of a pro-assisted-suicide lobby group provided the [required] consultation in 58 of 61 consecutive cases of patients receiving PAS [physician-assisted suicide]."

Depressed patients are dying without help

·"A recent Oregon-based study demonstrated that some depressed patients are slipping through the cracks. Among terminally ill patients who received a prescription for a lethal drug, 1 in 6 had clinical depression."

The social slippery slope is expanding medical killing without limit

·"Until 2001, the Netherlands allowed only adults access to euthanasia or PAS. However, the 2001 law allowed for children aged 12–16 years to be euthanized if consent is provided by their parents, even though this age group is generally not considered capable of making such decisions. The law even allows physicians to proceed with euthanasia if there is disagreement between the parents.

·"By 2005, the Groningen Protocol, which allows euthanasia of newborns and younger children who are expected to have “no hope of a good quality of life,” was implemented."

·"By 2006, the Royal Dutch Medical Association had declared that 'being over the age of 70 and tired of living' should be an acceptable reason for requesting eutha­nasia."

·"Denying euthanasia or PAS in the Netherlands is now considered a form of discrimination against people with chronic illness, whether the illness be physical or psychological…"

Palliative (comfort) care is giving way to cost-efficient medical killing

·"There is evidence that attracting doctors to train in and provide palliative care [in the Netherlands] was made more difficult because of access to euthanasia and PAS, perceived by some to present easier solutions, because providing palliative care requires competencies and emotional and time commitments on the part of the clinician

·"[In Belgium,] the rates of pal­liative care involvement have been decreasing. In 2002, palliative care teams were consulted in 19% of euthanasia cases, but by 2007 such involvement had declined to 9% of cases. That finding contradicts claims that in Belgium, legalization has been accom­panied by significant improvements in palliative care in the country."

·"At the United Kingdom’s parliamentary hearings on euthanasia a few years ago, one Dutch physician asserted that “We don’t need palliative medicine, we practice euthanasia.”

·Euthanasia and assisted suicide are carried out in the name of compassion despite the fact that proven medical "strategies are available to begin to address severe refractory symptoms, to treat depression, and to deal with the fear that some people have of what the future with a terminal disease may hold."

﻿﻿An interview published in the Public Discourse, excerpted below, offers an enlightening shared perspective by two bioethicists normally at odds with one another: Robby George (RG) of Princeton University and Art Caplan (AC) of the University of Pennsylvania. Both are smarter than I, so I will let them do the explaining:On the need for moral guidance of science﻿﻿

R. George

RG: "Bioethics is ethics, and ethics is about right and wrong. We know you can’t go about figuring out what’s right and wrong by scientific methods. So the norms have to come from somewhere else. And since we are a democratically constituted people, we are going to have to resolve by democratic procedures disputes about what the norms are, and how they apply in particular cases. Now that, I’m afraid, is politics. Not in some pejorative sense—rather in a good sense, in the democratic sense. Together, we deliberate, debate, and decide. So I think the juxtaposition that you mentioned is just phony. It’s not a dispute between the people “who believe in reason and evidence” and people who 'are opposed to science.'"﻿﻿

A. Caplan

AC: "You can pile up evidence to the size of the Jungfrau, but if you don’t have norms, evidence does you no good. But some out there believe that the evidence speaks for itself."On embryonic stem cell research hype:RG: "To me, at stake was our fidelity to the principle of the sanctity of human life. So I could not have yielded and said, “Well, that’s not important.” At the level of principle, I think probably both sides would say that it’s a big issue. But my sense is that it got blown enormously out of proportion as far as the practical significance of a policy one way or another was concerned. First, because it became useful politically. It was a way for Democrats to marshal their base against Bush in 2004. Ron Reagan, the late president’s very liberal son, to my mind just wildly hyped the potential therapeutic promise of embryonic stem cells. I think a lot of people were led to believe—and to what extent scientists were responsible for this is an interesting question—that if only the regulations were relaxed, embryonic stem-cell science would be central to our medical research and practice going into the future, and that it would massively alleviate suffering and produce cures for dreaded diseases. But it wasn’t true. Prescinding from the ethical questions, my own view is that there are scientifically interesting things that can come of embryonic stem-cell research, but that even without regulation, it wouldn’t be central. It doesn’t promise anytime soon, if ever, the amelioration of suffering or cures for dreaded diseases."AC: "So far I don’t disagree with that too much. Embryonic stem-cell research was completely overhyped, in terms of its promise. And people knew it at the time. I tried to say so myself at different times myself, even though I support embryonic stem-cell research. But this notion that people would be out of their wheelchairs within a year if we could just get embryonic stem-cell research funded was just ludicrous. Just simply silly."

The Christian Medical Association (CMA) and the CMA-managed Freedom2Care coalition on conscience rights recently conducted a nationwide poll on conscience rights. The poll also included a question on respondent's self-identification as "pro-life" or "pro-choice" regarding abortion.On conscience rights, the poll found:
•77 percent of American adults surveyed said it is either “very” or “somewhat” important to them "that healthcare professionals in the U.S. are not forced to participate in procedures or practices to which they have moral objections." 16 percent said it is not important.
•50 percent of American adults surveyed "strongly" or "somewhat" support "a law under which federal agencies and other government bodies that receive federal funds could not discriminate against hospitals and healthcare professionals who decline to participate in abortions." 35 percent opposed.On abortion, the survey asked, "On the topic of abortion, do you consider yourself pro-life or pro-choice?" Kellyanne Conway, CEO, the polling company, inc., explains the results: "Americans were closely divided on the abortion issue, as a 46%-plurality was either firmly pro-life or leaned toward that viewpoint, and 43% self-identifying with a pro-choice affiliation. These data confirm years’ worth of other polling, including for CMA, that shows neither viewpoint claiming a majority of Americans, and slightly more calling themselves 'pro-life' than 'pro-choice.'”Technical notes: This nationwide survey of 1,000 Americans ages 18 and older was conducted April 29-May 2, 2011, at a Computer Assisted Telephone Interviewing (CATI) phone facility using live callers. The sample was drawn utilizing a Random Digit Dial (RDD) in which phone numbers were generated by a computer to ensure that every household in the nation had an equal chance to be surveyed. Sampling controls were used to ensure that a proportional and representative number of adults were interviewed from such demographic groups as age, gender, race and ethnicity, and geographic region. The margin of error is calculated at +/- 3.1 percent at the 95 percent confidence level, meaning that in 19 out of 20 cases, the results obtained would differ by no more than 3.1 percentage points in either direction if the entire adult population nationwide were to be surveyed.

Thursday, May 26, 2011

On Tuesday, I joined pro-life politicians and leaders in meeting in the U.S. Capitol with Rep. Virginia Foxx (R-NC-5th) and others to discuss and express support for her amendment to H.R. 1216, which would:

1.protect conscience rights in medical education, and;

2.prevent the use of tax funds for abortion training.

On Wednesday, by a vote of 234 to 182, the U.S. House of Representatives PASSED the Freedom2Care-backed amendment.

The amendment by Rep. Foxx would ensure that none of the funds authorized for qualified teaching health centers can be used to pay for “abortion or training in the provision of abortions.” The amendment also ensures that funds are not made available to any teaching health center that discriminates against individual or institutional health care entities on the basis that the entity does not “provide, pay for provide coverage of, or refer for abortions.”

The Patient Protection and Affordable Care Act (P.L. 111-148, "Obamacare") created direct funding for graduate medical education in qualified teaching health centers, which are defined as community based, ambulatory patient care centers that operate a primary care residency program. H.R. 1216 removes the (mandatory) direct funding stream for this program and instead makes funding for qualified teaching health centers contingent on the approval of Congress.

Wednesday, May 18, 2011

While proposing some sound strategies for healthcare reform in a USA Today commentary, Republican presidential hopeful Mitt Romney misses the elephant in the room: Looming physician shortages portend the loss of access for millions of patients.
Currently, 65 million people lack adequate access to primary care physicians.[1] Fifty medical studies have projected critical shortages of physicians.[2] The American Association of Medical Colleges concludes, “If physician supply and use patterns stay the same, the United States will experience a shortage of 124,000 full-time physicians by 2025.”[3]
Millions of patients, notably the poor and those in medically underserved regions, depend for care on religious healthcare institutions and professionals whose faith and conscience compel their service. Faith-based health care depends on protections against discrimination for upholding life-affirming ethical standards.
Absent conscience protection, nine of ten faith-based physicians say they would be forced to leave medicine.[4] Yet the Obama administration eviscerated the only federal regulation that protected the exercise of conscience in health care, and partisans in the last Congress shot down amendments to protect conscience in Obamacare.
Cost reduction, malpractice reform and market competition remain key to healthcare transformation. Yet any successful healthcare policy must first protect patient access, which hinges on preserving physicians' freedom to care for patients according to conscience and ethical standards.

Thursday, May 12, 2011

Yesterday the Bioethics Defense Fund filed a brief outlining a potentially significant argument in a court case against Obamacare: that the law violates the free exercise clause of the First Amendment of the U.S. Constitution ("Congress shall make no law respecting an establishment of religion, or prohibiting the free exercise thereof...").The amicus, or "friend of the court" brief, filed on behalf of the Christian Medical Association, the Catholic Medical Association and Medical Students for Life, argues that the U.S. Court of Appeals for the 11th Circuit should affirm the decision of the U.S. District Court for the Northern District of Florida that the individual mandate in the health care law is unconstitutional.

The brief argues that:

The way the PPACA law (Obamacare) is structured, individuals are forced to subsidize abortion coverage out of their own pockets (the brief does not address the question of whether it also includes tax subsidies).

If the law were a generally applicable law, the government would have more leeway to impose a burden upon religion. However, the law is not a generally applicable law, as evidenced in part by the hundreds of exemptions that the U.S. Dept. of Health and Human Service (HHS) has already granted. None of these exemptions has been based on religious objection to abortion; therefore HHS is discriminating against religion by equating religious objections as less important than non-religious objections.

As a non-generally applicable law, the government faces a strict scrutiny test that provides less leeway for government imposition and stronger protections for religion.

The law does not meet the strict scrutiny test, since religious objectors to abortion are forced to subsidize abortion coverage.

Therefore, the law violates the First Amendment assurance of the free exercise of religion.

Here's the news release of the Bioethics Defense Fund with more detail:Amicus Brief Exposes Unconstitutional "Abortion Premium Mandate" in Obamacare

May 11, 2011. Bioethics Defense Fund (BDF) has filed an amicus brief on behalf of three pro-life medical associations presenting a unique additional reason why the so-called Obamacare Act is unconstitutional: its individual mandate also imposes and “abortion premium mandate” that violates the Free Exercise Clause of the First Amendment.

The amicus brief was filed in the Eleventh Circuit Court of Appeals in support of the twenty-six State Attorneys General, on behalf of the Catholic Medical Association, the Christian Medical and Dental Association, and Medical Students for Life.

The brief is the first to oppose the individual mandate based on a detailed outline of the abortion provisions found in Section 1303 of the Patient Protection and Affordable Care Act. Added on the Senate side as part of the “Nelson Compromise,” the provisions mandate that certain issuers “shall” obtain, without exception, a separate premium from each enrollee’s own pocket to be used solely for the payment of other people’s elective abortions.

Even though the language was intended to prohibit an individual’s use of government subsidies for abortion coverage, “Congress cannot meet that goal by unconstitutionally forcing Americans to personally foot the bill for abortion, in violation of their sincerely held religious beliefs,” said BDF president and general counsel Nikolas T. Nikas.

According to co-counsel Mark Rienzi of Columbus School of Law, “the Supreme Court has allowed government imposed burdens on free exercise only if the law is ‘neutral and generally applicable.’” But he says that the Act does not even come close to meeting that standard.

According to BDF senior counsel Dorinda C. Bordlee, “the individual mandate provides for limited religious exemptions – but only for those who religiously oppose insurance benefits, not abortion; and, the Secretary herself has issued hundreds of waivers to the individual mandate on a on a case by case basis. This shows that the law is not generally applicable and that Congress really has no compelling interest in forcing all Americans to purchase health insurance, especially when it forces them to personally pay a designated abortion premium.”

Bioethics Defense Fund senior counsel Dorinda C. Bordlee filed the brief as counsel of record, along with BDF general counsel Nikolas T. Nikas. Co-counsel include Mark Rienzi, Assistant Professor at the Columbus School of Law, Catholic University of America; Timothy J. Casey; and Christopher A. Ferrara of the American Catholic Lawyers Association.

No Democrats have cosponsored S. 906 at this time. Senators such as Casey, Conrad, Manchin, Nelson (NE) and Pryor should be encouraged to cosponsor S. 906. Action: Use the Freedom2Care Legislative Action Center to urge your senator to co-sponsor this bill, or to thank him or her for co-sponsoring the bill.More information is available in the press release from Senator Wicker.

The Freedom2Care coalition web site now offers a Legislative Action Center that makes it easy for users to learn about and track bills, contact their legislators and more.For example, if you would like to find out how your Representative voted this week on H.R. 3, the No Taxpayer Funding for Abortions Act, which provides conscience protections in health care, click on this link.This page also provides you with an easy-to-use thank-you email to your Representative.You'll also be able to use this site to conveniently track the various bills related to conscience rights.

Wednesday, May 4, 2011

Yesterday Emergency Medicine expert Dr. Ed Read (center in picture) and colleagues and I briefed legislators including Rep. Chris Smith (at left) on the conscience-related aspects of H.R. 3, the No Taxpayer Funding for Abortions bill. The House debated the bill today and Members are now considering how to vote very soon.

Monday, May 2, 2011

The U.S. House of Representatives on Wed., May 3 will debate a key bill that will protect conscience rights in health care.

Contact your U.S. Representative now to urge a YES vote on H.R. 3, the No Taxpayer Funding for Abortion Act.

The bill provides the following conscience protections in health care:

"A Federal agency or program, and any State or local government that receives Federal financial assistance (either directly or indirectly), may not subject any individual or institutional health care entity to discrimination on the basis that the health care entity does not provide, pay for, provide coverage of, or refer for abortions."